Sentinel lymph node micrometastasis and other histologic factors that predict outcome in patients with thicker melanomas

Cherpelis, Basil S.; Haddad, F.; Messina, Jane L.; Cantor, Alan; Fitzmorris, Kristi; Reintgen, Douglas S.; Fenske, Neil A.; Glass, L. Frank

doi:10.1067/mjd.2001.112346

Cited by 78 publications

(53 citation statements)

References 9 publications

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“…It may be argued that there is little value associated with SLNB in patients with thick melanomas since there is a high rate of systemic and/or regional disease at the time of diagnosis, and that the prognostic utility of SLNB is lower in these patients [Perrott et al, 2003]. Other studies reinforced this belief by demonstrating no significant difference in overall survival in patients who undergo SLNB for thick melanomas relative to those who do not [Cherpelis et al, 2001;Essner et al, 2002;Jacobs et al, 2004]. However, a study done by Gajdos et al demonstrated that patients with T4 tumors with a negative SLNB experienced a longer disease-free and overall survival than those with a positive SLNB [Gajdos et al, 2009].…”

Section: Surgical Management Of Melanocytic Lesions Of Uncertain Malimentioning

confidence: 52%

Challenging Problems in the Surgical Management of Melanoma

Ganapathi¹,

Tyler²,

Mosca³

2011

Current Management of Malignant Melanoma

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Section: Surgical Management Of Melanocytic Lesions Of Uncertain Malimentioning

confidence: 52%

Challenging Problems in the Surgical Management of Melanoma

Ganapathi¹,

Tyler²,

Mosca³

2011

Current Management of Malignant Melanoma

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“…Of these, 166 were alive without disease. Their results indicated that the status of the sentinel lymph node is predictive of disease-free survival for patients with thick melanoma 4 . Studying 131 patients with T4 melanoma, Gershenwald et al observed that patients with negative sentinel lymph node and no ulcerations had a rate of threeyear overall survival of 86%, while patients with T4 melanoma with positive sentinel lymph node and presence of ulceration had the same rate of t of 57% (P <0.03) 5 .…”

Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 96%

A biópsia de linfonodo sentinela não deve ser recomendada para pacientes portadores de melanoma espesso

Filho¹,

Silva²,

Oliveira

et al. 2013

Rev. Col. Bras. Cir.

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OBJETIVO: verificar se há alguma relação entre o estado histopatológico do linfonodo sentinela, a recorrência e a mortalidade decorrente do melanoma espesso em pacientes submetidos à BLS ao longo de um seguimento significante. MÉTODOS: Oitenta e seis pacientes portadores de melanoma espesso submetidos à BLS foram selecionados de um banco de dados prospectivo. A linfocintilografia, o mapeamento linfático e a detecção gama intraoperatória foram realizados em todos pacientes. O linfonodo sentinela (LS) foi analisado por HE e por imunoistoquímica. Linfadenectomia total foi indicada para os pacientes com LS positivo. O estado histopatológico do LS foi relacionado à taxa de recorrência e de mortalidade por melanoma. RESULTADOS: Cento e sessenta e seis LS foram retirados dos 86 pacientes. As idades variaram de 18 a 73 anos. Havia 47 mulheres e 39 homens. Micrometástases foram encontradas em 44 pacientes. Quarenta e dois pacientes foram submetidos à linfadenectomia total. Sete pacientes tiveram outro linfonodo positivo. Entre os 44 pacientes com LS positivo houve 20 recorrências e 15 mortes. Houve 18 recidivas e 12 mortes no grupo de LS negativo. A espessura de Breslow não apresentou correlação com o estado histopatológico do LS. O estado histopatológico do LS não interferiu nas taxas de recorrência e de mortalidade (teste de Fisher, p=1.00). A mediana de seguimento foi 69 meses. CONCLUSÃO: Considerando a falta de evidência de benefício, a BLS não deve ser indicada para pacientes com melanoma espesso fora de estudos clínicos.

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“…In other words, for a tumor that is over 4 mm thick, it is highly possible that cancer cells have already metastasize via hematogenous spread, so the sentinel nodal status does not significantly affect the prognosis 18 . However, Cherpelis et al 16 reported that in regards to a tumor thickness of over 3 mm, the difference in the 3 year disease-free survival for the positive and negative SLNB patients showed statistically meaningful results (73% vs 37%). Though SLNB still has debatable factors, it is true that SLNB has enabled more accurate pathologic staging, and so patients could avoid unnecessary treatment such as elective lymph node dissection.…”

Section: Discussionmentioning

confidence: 99%

“…The 'watch-and-wait policy' was previously applied to melanoma patients with clinically-negative lymph nodes and who underwent wide excision of the primary melanoma with a 1 or 2 cm margin according to the Breslow thickness. When lymph nodes became palpable during follow-up procedures, then therapeutic lymph node dissection was performed 16,17 . Yet recently, if SLNB detects positive node(s), then a complete lymph node dissection is performed.…”

Section: Discussionmentioning

confidence: 99%

The Feasibility of Sentinel Lymph Node Biopsy with a Multidisciplinary Cooperative Team Approach for the Management of Koreans with Cutaneous Malignant Melanoma

et al. 2010

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Background:The regional lymph nodal status is the most powerful independent predictor of survival for patients with clinical N0 primary cutaneous malignant melanoma. Objective: We wanted to evaluate the feasibility and morbidity of the sentinel lymph node biopsy (SLNB) staging using a multidisciplinary team approach, in cooperation with other surgical departments, at a university hospital setting. Methods: Twenty two patients with cutaneous melanoma and who were treated at Kyungpook National University Hospital were included in this study. They all received SLNB, which was done by the Departments of Dermatology and General Surgery. We evaluated the feasibility and side effects of SLNB. Results: Pathologicallypositive sentinel nodes were found in 7 of the 22 cases (31.8%) and all 7 patients were consequently upstaged. The whole process involved in SLNB was well tolerated by nearly all the patients, with only mild and transient complications being observed. Conclusion: We suggest that in a Korean setting, utilizing SLNB with a multi-disciplinary team approach is a technically feasible procedure that is able to detect occult nodal metastasis with low morbidity rates in patients with cutaneous malignant melanoma. (Ann Dermatol 22(1) 26∼34, 2010)

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Sentinel lymph node micrometastasis and other histologic factors that predict outcome in patients with thicker melanomas

Cited by 78 publications

References 9 publications

Challenging Problems in the Surgical Management of Melanoma

Challenging Problems in the Surgical Management of Melanoma

A biópsia de linfonodo sentinela não deve ser recomendada para pacientes portadores de melanoma espesso

The Feasibility of Sentinel Lymph Node Biopsy with a Multidisciplinary Cooperative Team Approach for the Management of Koreans with Cutaneous Malignant Melanoma

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